<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus1')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus1" class="form-control" step="0.01" name="row[bonus1]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus2')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus2" class="form-control" step="0.01" name="row[bonus2]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus3')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus3" class="form-control" step="0.01" name="row[bonus3]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus4')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus4" class="form-control" step="0.01" name="row[bonus4]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus5')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus5" class="form-control" step="0.01" name="row[bonus5]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus6')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus6" class="form-control" step="0.01" name="row[bonus6]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus7')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus7" class="form-control" step="0.01" name="row[bonus7]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus8')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus8" class="form-control" step="0.01" name="row[bonus8]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Total')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-total" class="form-control" step="0.01" name="row[total]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Count_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-count_date" class="form-control" name="row[count_date]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tax_money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tax_money" class="form-control" step="0.01" name="row[tax_money]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
